Billing code 61020: Ventricular drainageMedicare rate & RVUs in Utah
Reports direct puncture of a brain ventricle to drain fluid therapeutically, rather than accessing fluid through a shunt or another CSF space.
CMS doesn’t publish an office rate for 61020 in Utah.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
On this page 9 sections
What 61020 covers
A neurosurgeon uses a needle or other ventricular access to remove fluid directly from a brain ventricle for therapeutic drainage. The service may be performed in a hospital or another setting with appropriate procedural support when ventricular fluid removal is clinically needed, such as managing hydrocephalus or elevated intracranial pressure. This code concerns direct ventricular access, not a tap of an existing shunt reservoir or drainage from the cisterna magna.
Report the service when the documented procedure is therapeutic drainage by direct ventricular puncture. The operative or procedure note should identify the ventricular access and the drainage performed; a shunt tap or an injection-only service calls for a different code. Medicare assigns a 0-day global period, so same-day preoperative and postoperative care is included. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Modifier 50 is inappropriate. Medicare does not pay an assistant at surgery for this service; co-surgeons and team surgery are not permitted.
This summary was written with AI assistance from CMS physician fee schedule data and checked against the CMS billing rules shown here. Rates on this page come directly from CMS files.
61020 in Utah
| Payment locality | Office | Facility |
|---|---|---|
| Utah | Unavailable | $94.85 |
How the 61020 rate is calculated
Each of 61020’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.
How the rate is built · 61020
RVUs × geographic indexes × conversion factor
Work1.47
1.47 RVUs× 1.000 GPCI
Practice expense0.97
0.97 RVUs× 1.000 GPCI
Malpractice0.51
0.51 RVUs× 1.000 GPCI
Adjusted RVUs
2.9500
Conversion factor
$33.4009
Medicare rate
$98.53
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 61020
The CMS indicators that decide how 61020 is paid alongside other services.
CMS payment indicators · 61020
Ventricular drainage
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 000 | Same-day global: pre- and post-op care on the day of the procedure is included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 1 | Not paid (statutory restriction). |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
What modifiers do to the payment
Modifier 51 · payment effect
With and without the modifier
61020 without 51 · national facility
$98.53
Ventricular drainage
61020-51 · Second procedure: 50%
$49.27
When this isn’t the highest-valued procedure in the session, Medicare pays 50% of its fee schedule amount (the highest is paid at 100%).
61020 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 61000Subdural tap
- This code concerns access through shunt tubing or a reservoir. Code 61020 describes direct puncture of a brain ventricle for therapeutic drainage.
- 61050Cisternal puncture
- Code 61050 involves puncture of the cisterna magna. Code 61020 is selected when the documented drainage is from a brain ventricle.
- 61026Ventricular injection
- Code 61026 describes an injection into a brain canal; code 61020 reports therapeutic fluid drainage by direct ventricular puncture.
61020 billing questions
How is this different from a shunt tap?
This code is for direct puncture of a brain ventricle to drain fluid. When the provider accesses fluid through existing shunt tubing or a reservoir, consider the applicable shunt-puncture code instead.
When should a cisterna magna puncture be reported instead?
Use the cisterna magna code when the documented puncture and drainage involve that CSF space rather than a brain ventricle.
Is same-day preoperative or postoperative care separately payable?
No. The 0-day global period includes same-day preoperative and postoperative care.
Can modifier 50 be used for bilateral ventricular drainage?
No. The CMS bilateral adjustment does not apply, and modifier 50 is inappropriate for this service.
How does Medicare handle other procedures performed in the same session?
The highest-valued procedure is paid in full, and other procedures are subject to the standard multiple-procedure reduction. Medicare does not pay an assistant at surgery, and co-surgeon or team-surgery billing is not permitted.
Where these rates come from
FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.
CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027
Show the CMS file lines behind this rate
Fee sheets
Put 61020 and the rest of your codes on one sheet
Build a fee sheet from your own code list at your locality, put your payer contracts beside Medicare, and see what changed each quarter.
Build my fee sheetOr price your code list free →